Crotched Mountain Rehabilitation Center, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

CROTCHED MOUNTAIN REHABILITATION CENTER, INC.

Practice address

1 Verney Dr
Greenfield, NH 03047-5000

Phone

(603) 547-3311

Fax

(603) 547-3232

NPI assigned

Jun 25, 2006

Last updated

Jan 17, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kelly Ward

Title

VP of Finance

Phone

(603) 547-3311

Specialties & licenses 9

Addresses

Other identifiers 4

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705449600000",
    "number": "1891721262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 VERNEY DR",
            "city": "GREENFIELD",
            "state": "NH",
            "postal_code": "030475000",
            "telephone_number": "603-547-3311",
            "fax_number": "603-547-3232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 VERNEY DR",
            "city": "GREENFIELD",
            "state": "NH",
            "postal_code": "030475000",
            "telephone_number": "603-547-3311",
            "fax_number": "603-547-3232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROTCHED MOUNTAIN REHABILITATION CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-25",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "603-547-3311"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225800000X",
            "taxonomy_group": "",
            "desc": "Recreation Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NH",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC FACILITY #",
            "identifier": "0000005NA",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3076358",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC PROFESSIONAL GROUP #",
            "identifier": "50Y519400NH01",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1020140",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leo Benoit, COTA
• Jennifer Booth, OTR/L
• M. Shale Carey, MA
• Mark Steven Clark, PA
• William Carl Cooley, MD
• Amanda Cullity, MS, OTR/L
• Catherine Curtis, RNMSNAGPCNP-CCNLCCRN
• Jacquelyn A Dempsey, OTR/L
• Kimberly Detour, RD
• Holly M Di Rie, SLP

• Community/Behavioral Health Agency in Greenfield, NH
• Providers in Greenfield, NH by specialty
• Community/Behavioral Health Agency in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.